Historical Neurology

VIDEO Lou Gehrig, Rawhide, and 1938Melissa Lewis, BS; and Paul H. Gordon, MD

Abstract—Lou Gehrig was one of the most talented baseball players of all time; yet he is also remembered for ALS, thedisease that took his life and still bears his name as its eponym. There is speculation about when his symptoms began.Some authorities believe that Gehrig showed signs of ALS when he starred in the film Rawhide in January 1938, whichwould mean that he played the entire 1938 season with symptomatic ALS. Additionally, some photographs of Gehrigshowing atrophy of hand muscles have been dated incorrectly because of misinterpreted logos on his uniform. Weexamined the film and photos taken of Gehrig from 1937 to 1939 to determine whether he showed signs of weakness in thefilm and when visible evidence of ALS could be documented. Specific scenes from Rawhide were chosen to grade Gehrig’smotor function using the ALS Functional Rating Scale (ALSFRS). Dates of photos and uniform logos were verified withthe Baseball Hall of Fame. Examination of Rawhide showed that Gehrig functioned normally in January 1938. HisALSFRS score, modified to account for limitations of on-screen activities, was normal. The New York Yankees wore logosin 1938 that were labeled with the year 1939 to advertise the 1939 World’s Fair; the uniforms displayed a centennial patchduring the 1939 season. A photograph of Gehrig from October 1939 showed hand atrophy. Photos from the spring of 1938showed normal hand muscles and leg function, implying that visible signs first appeared after May 1938.

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Lou Gehrig signed with the New York Yankees in1923 and in June 1925 began a streak of 2,130 con-secutive games that ended only when he becameweak 14 years later. Despite numerous injuries, hewon four Most Valuable Player titles, played inseven World Series, and compiled exceptionalstatistics.1

In addition to his fame as a baseball player, Geh-rig is also widely remembered for the disease ALS,which took his life and, in the United States, bearshis name. In contracting ALS, he raised publicawareness of the disease. Eleanor Gehrig, his wife,with the aid of her executor, George Polack, latergave his name and part of their estate to support aresearch center at Columbia University, the Eleanorand Lou Gehrig MDA/ALS Research Center2 (LewisP. Rowland, MD, personal communication).

Gehrig was a superb athlete, but he was also astoic man. His quiet nature and lack of examinationby a neurologist in New York when he first had

weakness3 have made it difficult to identify his firstsymptoms.4 He died in 1941, just 2 years after hestopped playing, and some photographs of Gehrigshowing hand atrophy were taken while he was stillin uniform.4,5 Some authorities believe that handmuscle atrophy and leg weakness were evident asearly as the winter prior to the 1938 season when hestarred in the film Rawhide; he used a Gowers ma-neuver to rise from the ground several times in thefilm.6,7 Eleanor Gehrig and other players noticedsymptoms with certainty after the 1938 season.2,8

Methods. We examined the film Rawhide, which was shot inJanuary 1938,4,7 and inspected photos taken of Gehrig from 1937to 1939 to elucidate the timing of Gehrig’s first publicly visiblesigns of ALS. Specific scenes from the movie were chosen to grademuscle function using the ALS Functional Rating Scale (ALS-FRS). Unambiguous scenes were selected to examine his hands forevidence of atrophy and to assess limb function, with the time ofeach scene noted. His Mayo Clinic records have been kept confi-dential and could not be reviewed (Eric Sorenson, personalcommunication).

We reviewed published photos4,5 and others in the BaseballHall of Fame that were taken of Gehrig in the years 1937 to 1939to determine when they were taken and whether there was evi-dence of hand atrophy or leg weakness. The dates of the photoswere verified with the Baseball Hall of Fame, where photographsare identified by a date stamped on the back or by an accompany-ing news article (John Horne, library associate at the Hall ofFame). Information on the dates of uniform logos was obtainedfrom a Major League Baseball uniforms book9 and from patchexpert Tom Schieber (senior curator at the Hall of Fame).

Results. Examination of Rawhide. Gehrig’s perfor-mance in Rawhide demonstrated good physical function.His ALSFRS score, modified to account for limitations ofon-screen activities, was normal (score � 32/32; table). Itwas not possible to grade dressing, hygiene, or turning in

From the Eleanor and Lou Gehrig MDA/ALS Research Center, Departmentof Neurology, Columbia University, New York.Supported by the Wings Over Wall Street Fund.Disclosure: The authors report no conflicts of interest.Received July 13, 2006. Accepted in final form November 6, 2006.Address correspondence and reprint requests to Dr. P.H. Gordon, Neurolog-ical Institute, 710 W. 168 St., 9th fl., New York, NY 10032; e-mail:phg8@columbia.edu

Additional material related to this article can be found on the NeurologyWeb site. Go to www.neurology.org and scroll down the Table of Con-tents to the February 20 issue to find the title link for this article.

Copyright © 2007 by AAN Enterprises, Inc. 615

bed because Gehrig did not perform these activities in thefilm.

Gehrig showed no bulbar signs in the film. His speechwas normal; he spoke clearly and shouted on several occa-sions (1:30, 49:50). He took a bite and chewed a sandwich(43:00).

Gehrig demonstrated normal upper body strengththroughout a bar fight in which he lifted an adult manoverhead and threw him to the ground (22:00). Other shotsshowed normal bulk in the muscles of both hands (12:10 to12:30, 24:40; see video segments 1 and 2 at www.neurolo-gy.org). Although left-handed, Gehrig wrote with his righthand. He signed an autograph showing normal writingability and no atrophy in the right hand (1:40). Later, hehandled teacups with ease (24:25); he also tied severalknots in a rope (18:35), which, taken together with the teascene, were used to substitute for the action of handlingutensils.

Throughout the film, Gehrig exhibited good legstrength. He mounted and dismounted a horse, walkedbriskly (13:20), ran, and squatted to the ground (18:15). Heclimbed and descended stairs (47:50, 48:15) and was ableto bend beneath a hitching post (48:15). Several times Ge-hrig rose from a seated position without using his armsand hands to push himself up. He exited a car (11:55),hopped to a stand from a seated position (16:30; videosegment 3), and later rose from a bench while clapping hishands (41:50; video segment 2). At the end of the film, heleaped over a chair (57:56; video segment 4).

Gehrig’s breathing seemed normal during action scenes,and he maintained strong voice volume during conversa-tion. He also showed normal diaphragm excursion when hesighed visibly in one scene (12:07).

Examination of photos. The New York Yankees worelogos in 1938 that were labeled with the year 1939 toadvertise the 1939 World’s Fair, while all professionalbaseball uniforms displayed a centennial patch celebrating100 years of baseball during the 1939 season (figure 1). Aphotograph from May 1938 shows normal left hand bulkand suggests normal leg function (figure 2). A photographof Gehrig taking a swing in September 1938 implies goodleg strength (figure 3). Photographs from 1937 are consis-tent with the ones from 1938, whereas photographs fromthe 1939 season show visible hand atrophy. One previously

Table ALS Functional Rating Scale for Lou Gehrig (January1938)

1. Speech4 normal speech processes3 detectable speech disturbance2 intelligible with repeating1 speech combined with nonvocal communication0 loss of useful speech

2. Salivation4 normal3 slight but definite excess of saliva in mouth, may have nighttime

drooling2 moderately excessive saliva, may have minimal drooling1 marked excess of saliva with some drooling0 marked drooling, requires constant tissue

3. Swallowing4 normal eating habits3 early eating problems, occasional choking2 dietary consistency changes1 needs supplemental tube feedings0 NPO (exclusively parenteral or enteral feedings)

4. Handwriting4 normal3 slow or sloppy, all words legible2 not all words legible1 able to grip pen, unable to write0 unable to grip pen

5a. Cutting Food and Handling Utensils (patients without gastrostomy)4 normal3 somewhat slow and clumsy, needs no help2 can cut most foods, slow or clumsy, some help needed1 foods cut by someone else, can still feed slowly0 needs to be fed

5b. Cutting Food and Handling Utensils (patients with gastrostomy)4 normal3 clumsy, able to perform all manipulations2 some help needed with closures and fasteners1 provides minimal assistance to caregiver0 unable to perform any aspect of task

6. Dressing and Hygiene4 normal3 independent self care with effort or decreased efficiency2 intermittent assistance or substitute methods1 needs attendant for self care0 total dependence

7. Turning in Bed and Adjusting Bedclothes4 normal3 somewhat slow or clumsy, needs no help2 can turn alone or adjust sheets with great difficulty1 can initiate, cannot turn or adjust sheets0 helpless

8. Walking4 normal3 early ambulation difficulties2 walks with assistance1 nonambulatory functional movement only0 no purposeful leg movement

9. Climbing Stairs4 normal3 slow2 mild unsteadiness or fatigue1 needs assistance0 cannot do

10. Breathing4 normal (no change in breathing compared to prior to ALS onset)3 shortness of breath with minimal exertion (eg, walking talking)2 shortness of breath at rest1 intermittent (eg, nocturnal) ventilator assistance0 ventilator dependent

Modified Score: 32/32

ALS Functional Rating Scale: Lou Gehrig, January 1938. Based on his perfor-mance in the movie Rawhide, the relevant questions on the ALS FunctionalRating Scale were answered. The activities of dressing/hygiene and turning inbed/adjusting the bedclothes could not be assessed owing to limitations in hison-screen actions. Gehrig was given a score of 32 of 32 on a shortened scale.

Figure 1. Uniform logos. The uniform logo on the left dis-plays an advertisement for the 1939 World’s Fair. Thethree New York teams wore this logo on the sleeve of theiruniforms in 1938. The photo on the right shows the cen-tennial patch that was worn by all professional baseballplayers in 1939. The logos can be used to discriminate be-tween photos taken of Gehrig in 1938 and 1939.

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published photograph with hand atrophy5 could not bedated with certainty, but was most likely shot in October1938 (John Horne, Baseball Hall of Fame). The first iden-tified photograph showing clear hand atrophy where boththe month and the year are known was taken in October1939 (figure 4).

Conclusion. Gehrig’s reserved nature makes itdifficult to construct a clear timeline of the onset andprogression of the disease. Newspaper quotes fromGehrig suggest that he attributed his decline to de-conditioning and that he minimized his early symp-

toms.10 Opinions about his symptoms by hiscontemporary ball players have the benefit ofhindsight.11

Gehrig’s fame as a star baseball player, matchedby his legacy in ALS, makes correcting the historicalrecord of his life important. By directly examiningfilm footage and photographs, we documented hisphysical condition in 1938 and 1939 to the extentpossible from publicly available images.

Several scenes from the film Rawhide illustrateexceptional strength and coordination consistent

Figure 2. Gehrig at first base, May1938. This photograph depicts Gehrig’snormal-appearing left hand muscula-ture. His stance supports normal legfunction.

Figure 3. Gehrig mid-swing at Comis-key Park, September 1938. The deepsquat captured in the photo lends sup-port to good leg function.

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with his profile as top athlete. A scene in which helifted an adult man over his head has been viewedframe by frame to ensure that Gehrig and not astunt double performed the feat.4 Gehrig sufferednumerous injuries to his hands during his career,which explains the deformity of his left fifth fin-ger,2,12 but his hands showed normal musculature inthe film.

Several occasions in which Gehrig placed hishands on his legs or the arms of a chair as he stoodup seem to reflect his acting technique rather than aphysical need. In other instances, Gehrig rose from aseated position without the use of his hands. A photosnapped mid-swing from September of 1938 seasonshows Gehrig in a deep squat, a stance that would bedifficult for someone with leg weakness to perform.

Contributing to the complexity of establishing aclear timeline for his symptoms, the literature con-tains occasional photographs of Gehrig that were re-ported as taken in 1939 when in fact they were shotin 1938. The 1939 World’s Fair patch, identified bythe Baseball Hall of Fame, was worn by the threeNew York City teams in 1938. The 1939 uniformsbore a centennial patch, allowing for discriminationbetween years but not the month.9

An analysis of his batting average, probably themost sensitive measure of symptom onset in a pro-fessional baseball player, showed that he began the1938 season at a lower but steady percentage com-pared with previous years and that his average de-clined markedly after June 1938.6 It is likely thatdenervation severe enough to cause visible atrophyor leg weakness would follow, not precede, a declinein as sensitive a measure of athleticism as battingaverage.

A careful examination of the western film Raw-hide provides compelling evidence that baseballgreat Lou Gehrig functioned normally in January1938; we found no evidence of hand atrophy or legweakness in the film. Uniform patches, correctlyidentified, can be used to discriminate between pho-tos of Gehrig taken in 1938 and 1939. Photos takenas late as September 1938 show apparently good legstrength, and images from late 1938 and 1939 showhand atrophy. Photographs taken in May 1938showed normal hand bulk and imply that there wasno visible evidence of ALS prior to mid-season 1938.

References1. National Baseball Hall of Fame. World wide web URL: http://www.

baseballhalloffame.org/hofers%5Fand%5Fhonorees/hofer%5Fbios/gehrig%5Flou.htm

2. Innes AM, Chudley AE. Genetic landmarks through philately—HenryLouis “Lou” Gehrig and amyotrophic lateral sclerosis. Clin Genet 1999;56:425–427.

3. Rowland LP. Luckiest man: the life and death of Lou Gehrig, LouGehrig: a biography. N Engl J Med 2005;8:353. Book review.

4. Eig Jonathan. Luckiest man. The life and death of Lou Gehrig. NewYork: Simon and Schuster, 2005.

5. Nathanson M. Lou Gehrig: a brief commentary. Neurology 1986;36:1349.

6. Kasarskis EJ, Winslow M. When did Lou Gehrig’s personal illnessbegin? Neurology 1989;39:1243–1245.

7. Rawhide. Alpha Video, August 2004. Original release, 1938.8. Gordon PH. History of ALS. In: Mitsumoto H, Przedborski, Gordon PH,

eds. Amyotrophic lateral sclerosis. New York: Taylor & Francis, 2006:1–13.

9. Okkonen Marc. Baseball uniforms of the 20th century: the official Ma-jor League Baseball guide. Sterling, 1991.

10. Daniel Dan. “Not through!” says Gehrig. NY World Telegram, April 28,1939.

11. Cavicke D, O’Leary P. Lou Gehrig’s death. Am Surg 2001;67:393–395.12. Official Website of Lou Gehrig. World Wide Web URL: http://www.

lougehrig.com

Figure 4. Gehrig with Yankees managerJoe McCarthy, World Series 1939. Thisphotograph taken in October 1939shows visible hand atrophy and can beused as a point of comparison with ear-lier photos.

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